Obama administration retreats on one aspect of health reform

BMJ 2011; 343 doi: (Published 17 October 2011) Cite this as: BMJ 2011;343:d6713
  1. Bob Roehr
  1. 1Washington, DC

The Obama administration has backed away from one component of the Affordable Care Act, the landmark 2010 health reform legislation.

The community living assistance services and support (CLASS) programme was to provide small cash payments to qualifying beneficiaries to purchase in-home assistance during periods of disability (BMJ 2009;339:b4398, doi:10.1136/bmj.b4398).

However, Congress did not want to create a new, open ended entitlement programme. It insisted that CLASS be voluntary and completely self funded insurance, “actuarially sound and solvent for at least 75 years.” Proponents argued that this could be accomplished by requiring payment of premiums for …

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